department of growth management...florida -nascla contractors guide to business, law and project...
TRANSCRIPT
Department of Growth Management
CLASS B AIR CONDITIONING CONTRACTOR
ldquoClass B Air Conditioning Contractorrdquo means a contractor whose services are limited to
twenty-five (25) tons of cooling and five hundred thousand (500000) BTUrsquos of heating in any
one system in the execution of contracts requiring the experience knowledge and skill to install
maintain repair fabricate alter extend or design when not prohibited by law central air-
conditioning refrigeration heating and ventilating systems including duct work in connection
with a complete system only to the extend such duct work is performed by the contractor as is
necessary to make complete an air-distribution system being installed under this classification
and any duct cleaning and equipment sanitizing which requires at least a partial disassembling of
the system to install maintain repair fabricate alter extend or design when not prohibited by
law piping and insulation of pipes vessels and ducts to replace disconnect or reconnect power
wiring on the load side of the dedicated existing electrical disconnect switch to install
disconnect and reconnect low voltage heating ventilating and air-conditioning control wiring
and to install a condensate drain from an air- conditioning unit to an existing safe waste or other
approved disposal other than a direct connection to a sanitary system The scope of work for such
contractor shall also include any excavation work incidental thereto but shall not include any
work such as liquefied petroleum or natural gas fuel lines within buildings except for
disconnecting or reconnecting change outs of liquefied petroleum or natural gas appliances within
buildings potable water lines or connections thereto sanitary sewer lines swimming pool piping
and filters or electrical power wiring
ALL APPLICANTS MUST BE 22 YEARS OF AGE OR OLDER
Okaloosa County requires applicants for State Registered or Local Specialty Licenses to
appear before the appropriate competency Board for approval prior to testing
Information Enclosed with Packet
1 Board Dates and Deadlines
2 Credit Reporting Agency Approved List
3 Application for Board Approval Affidavit
4 Mechanical Contractor Experience Affidavit
5 Work History Affidavit
6 Acknowledgement of ExamLicensure Deadline Affidavit
7 Master Limited (Class B) and Business amp Law Book List
8 Board Application Directions
Items required before Board appearance can be granted
____ Credit Report on yourself from a Department of Business and Professional
Regulation approved credit report agency (list enclosed in packet)
____ Proof of satisfaction of liens judgments and discharge of bankruptcy if applicable
____ Application for Board Approval Affidavit
____ Mechanical Contractor Experience Affidavit
____ Employment History Affidavit
____ Acknowledgement of ExamLicensure Deadline Affidavit
____ Copy of Driver License
____ $25 Board Processing fee (cash check money order MasterCard Visa or
Discover creditdebit cards) additional fees applied to creditdebit payments
Credit reports must be mailed directly to Okaloosa County Department of Growth Management from the credit agency NOTE Emailed credit reports will be accepted as long as they are sent directly from the credit reporting agency and can be verified PLEASE BE ADVISED If the credit report is submitted along with the required documents THE ENVELOPE MUST BE SEALED If the envelope is opened the credit report WILL NOT be accepted from the applicant
If you are interested in obtaining your State Certified license please call the Department
of Business amp Professional Regulation at (850) 478-1395 or visit
wwwmyfloridalicensecom for information
1250 N Eglin Parkway Suite 301 Shalimar FL 32579 812 E James Lee Blvd Crestview FL 32539
(850) 651-7526
License Form 09-0503
Revised October 2016
PLUMBING MECHANICAL amp CONSTRUCTION BOARD DATES FOR 2018
Board Board Meeting date Applicants deadline before
Board meeting
Agendarsquos Due
Plumbing - 9am
Mechanical ndash 10am
Construction ndash 3pm
January 31 2018 January 17 2018 January 24 2018
Plumbing ndash 9am
Mechanical ndash 10 am
Construction ndash 3pm
March 28 2018 March 14 2018 March 21 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
May 30 2018 May 16 2018 May 23 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
July 25 2018 July 11 2018 July 18 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
September 26 2018 September 12 2018 September 19 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
November 14 2018 October 31 2018 November 7 2018
ELECTRICAL BOARD DATES FOR 2018
Board Board Meeting date Applicants deadline before
Board meeting
Agendarsquos Due
Electrical ndash 3pm January 4 2018 December 14 2017 December 21 2017
Electrical ndash 3pm February 1 2018 January 18 2018 January 25 2018
Electrical ndash 3pm March 1 2018 February 15 2018 February 22 2018
Electrical ndash 3pm April 5 2018 March 22 2018 March 29 2018
Electrical ndash 3pm May 3 2018 April 19 2018 April 26 2018
Electrical ndash 3pm June 7 2018 May 24 2018 May 31 2018
Electrical ndash 3pm July 5 2018 June 21 2018 June 28 2018
Electrical ndash 3pm August 2 2018 July 19 2018 July 26 2018
Electrical ndash 3pm September 6 2018 August 23 2018 August 30 2018
Electrical ndash 3pm October 4 2018 September 20 2018 September 27 2018
Electrical ndash 3pm November 1 2018 October 18 2018 October 25 2018
Electrical ndash 3pm December 6 2018 November 15 2018 November 29 2018
______________________________________ ________________________
________________________________________ ______________________________
Department of Growth Management
Acknowledgement of ExamLicensure Deadlines
Per Okaloosa County Construction Ordinance 07-32 Section 3-3 and Okaloosa County
Electrical Ordinance 07-48 Section 3-3 Eligibility Licensure by Examination
From the date of Board approval an applicant shall have one (1) calendar year to have
taken and scored a grade of at least seventy-five percent (75) or above on the Standard
Business and Law Exam and on an examination in the particular field for which the
application is being made to be prepared proctored and graded by the approved testing
agency When the passing score is achieved the applicant shall proceed with application
for State licensure Upon receipt of a State license the applicant shall provide to the
Department of Growth Management the State License business tax receipt proof of
general liability insurance workerrsquos compensation exemptioninsurance and a hold
harmless agreement to obtain a Certificate of Competency The Department shall issue
the Certificate of Competency when the above mentioned documentation is provided and
all fees are paid in full
If an applicant fails to take the exam within the one (1) calendar year after Board
approval then the applicant will be required to reapply to the appropriate Board for re-
approval
Per Okaloosa County Construction Ordinance 07-32 Section 3-12 and Okaloosa County
Electrical Ordinance 07-48 Section 3-11 Undeclared Exam Applicants
Applicants must declare ldquoactiverdquo status in Okaloosa County within twelve (12) months
from date of notification of passing the examination If active status is not declared
within one (1) year from the date of the original notice the applicant must appear before
the Board for approval to retake the examination
By signing this affidavit I understand that I will have one (1) calendar year from the date
of Board approval to take and pass the appropriate exams I further acknowledge that if I
fail to complete the requirements I will be required to reapply as a new applicant in order
to obtain re-approval
I understand once I have passed the required exams I have twelve (12) months from the
exam notification date from the Growth Management Department to declare ldquoactiverdquo
status in Okaloosa County
Applicantrsquos Signature Date Signed
NOTARY INFORMATION
State of___________________________ County of___________________________
The above applicant whose name is _____________________________________
personally appeared before me and is known by me OR has produced the following
identification ___________________________________________________________
on this ____ day of ____________ 20_____
Notaryrsquos Signature Commission Expires
SEAL
License Form 57-0913
October 2016
__________________________________________________________________________________________
___________________________________________________________________________________________
_______________________________________________________ ________________________________
OKALOOSA COUNTY DEPARTMENT OF GROWTH MANAGEMENT APPLICATION FOR COMPETENCY BOARD APPROVAL
APPLICANTrsquoS NAME ____________________________________________________ DOB _________
MAILING ADDRESS ______________________________________________________________________________
CITYSTATEZIP ________________________________________________________________________________
WORK PHONE (____) ____________________________ HOME PHONE (____) ____________________________
MOBILE PHONE (____) ______________________________ FAX (____) __________________________________
EMAIL ADDRESS ________________________________________________________________________________
TYPE OF TRADE ________________________________________________________________________________
_____ Credit Report for Applicant
_____ Work History Affidavit
_____ Experience Affidavit for Applicant
_____ $25 fee
Receipt No ___________________ Total Paid ________________ Staff Initials ______________
_____ Have you ever been convicted of a felony YES or NO
_____ Have you ever been party to an entity that has been in any form of the construction business YES or NO
If ldquoyesrdquo please state the name(s) of all entities with which you are or have been associated
_____ Have you ever had a court judgment rendered against you that remains unsatisfied YES or NO
_____ Have you ever filed for bankruptcy protection in any state YES or NO
_____ Have you ever lost any license due to failure of the licensee to pay any debt or failure to abide by the requirements of the license YES or NO
If you answer ldquoyesrdquo to any of the above three (3) questions please attach an explanation
_____ If applying for Class A Class B or Master Mechanical license do you currently hold an EPA card allowing you to handle refrigerants
_____ If you have done business in any form of construction or building in any other state please disclose the state or states in which you were involved
_____ Drivers License
Affidavit of Applicant I hereby certify that the information contained herein is true and correct to the best of my knowledge and belief
Applicantrsquos Signature Date Signed
NOTARY STATE OF __________________________ COUNTY OF______________________________ Sworn to and subscribed before me this _____ day of ____________ 20___ By __________________________ Personally Known _____ OR Produced Identification ______Type of Identification Produced _______________
Notary Signature ________________________________________
SEAL
OFFICE USE ONLY
MEETING DATE ____________________________________
MOTION MADE BY _______________________________ SECONDED BY _______________________________
VOTE ______________________________________
License Form 51-0707
(January 2017)
Untitled Document Page 1 of 1
Prov 13614 Progress Blvd
Alachua FL 32615-9496 Telephone (866) 720-7768 Prov
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Information Bulletin
Business and Law
Number of Questions 50
Time allowed (hours) 2
Subject Area Quest
Business Organization 2 Licensing 3
Lien laws 2
Tax Laws 5 Safety OSHA 3
Labor Laws 8
Contract Management 9 Project Management 6 Estimating amp Bidding 4
Financial Management 5
Risk Management 3
References
FLORIDA - NASCLA Contractors Guide to Business Law and Project Management 1st ISBN 1-934234-92-3 OR 978-1shy934234-92-1 NASCLA 23309 N 17th Drive Building 1 Unit 110 Phoenix AZ 85027 Available at wwwnasclaorg or wwwprovbookstorecom Please note the Florida Business and Law Study Guide for Contractors (published by Prov) is permitted as a substitute
~shy
httpsarkivprovexamcomarkivtffcwebdllTenF oldFCSession=Arkiv4bd5ecb 1093dee 3132018
FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD Credit Reporting Agencies ndash For Reference Only
(This listing is not all inclusive You may submit credit reports from agencies not included on this list so long as they meet the criteria listed in 61G4-12011(12) Florida Administrative Code)
DBPR cannot recommend or endorse a particular credit reporting agency The list provided below includes the agencies that we are aware of that currently meet the Boardrsquos reporting requirements It is provided solely as a
courtesy to assist you in locating resources The Department specifically disclaims any responsibility for the quality or cost of services provided by the agencies listed below
Note to Applicants Effective April 10 2012 personal credit reports must contain a FICO derived credit score to meet application requirements It is the applicantrsquos responsibility to ensure the credit reporting agency includes
the FICO derived score on the credit report submitted to DBPR
1st United CRS dba wwwunitedcrscom PH 2392061049 PH 8505398000 PH 2155017224
A amp A Credit Corp
AAA Advantage Credit Services PH 8772964600
API Processing - Licensing Inc wwwapiprocessingcom PH 9545670013 PH 8009476939
Associated Credit Reporting Inc wwwassociatedcreditreportingcom PH 7542160025 PH 8006767640 (ext 201)
AVS Screening PH 8508622134
Background Research Inc
CBJ Associates Inc PH 9047235533
Check Mate PH 9413661819
Contractor Licensing Inc
Contractors Reporting Service PH 8004872084
Credit Bureau of Escambia County
Credit Bureau Services Inc dba wwwelicensereportcom PH 9545611400
Credit Business amp License Solutions dba wwwdbprcreditreportcom PH 8006002155
Credit Check Inc wwwcreditcheckinccom PH 5616165556 TOLL FREE 8776165556
Credit Plus Inc PH 8183311048
Credit Profile amp Security Corp
Credit Search PH 5617919458
Dragnet Credit amp Tenant Screening PH 3866767733
Licenses Etc wwwlicensesetccom PH 2397771028 PH 9545732700
License Exam Services LLC PH 9417062336
Lumbermenrsquos dba wwwFloridaCreditReportscom PH 9547712100 PH 8133587633 PH 4079562237 TOLL FREE 8004964826
MacData Inc
Merchantrsquos Association
Merit Credit wwwmeritcreditservicescom PH 2392773202 TOLL FREE 8003713348
NACM Tampa Inc Contact Cassie Thomas cthomasnacmtampacom PH 8003525882 Ext 292
NACM South Atlantic wwwnacmsouthatlanticcom PH 4072997491 Ext 115 TOLL FREE 8003936226
National Research Group PH 9414888500
Network Credit Services PH 8136855678
Premium Credit Bureau PH 3054681560
Supreme Credit Information Services wwwsupremebureaucomcastnet PH 7862661407 FAX 3056653315
USA Credit Bureau PH 8884742270
Updated 11818
Department of Growth Management Licensing Division
State of Florida
List of EPA Card Training amp Testing Providers
Mingledorffrsquos of Ft Walton Beach
76 Beal Pkwy SW
(850) 244-2017 (Additional locations in Pensacola and Panama City)
Johnston Supply of Ft Walton Beach
117 Hollywood Blvd NE
(850) 362-6880 (Additional locations in Pensacola and Panama City)
Wittichen Supply of Ft Walton Beach
125 Hollywood Blvd NE
(850) 664-2740
Locklin Vo-Tech
5330 Berryhill Road
Milton
(850) 983-5700
Choice Applied Tech
1976 Lewis Turner Blvd
Ft Walton Beach
(850) 833-3500
812 E James Lee Blvd
Crestview FL 32539
(850) 651-7526 (850) 651-7184 FAX
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
PLUMBING MECHANICAL amp CONSTRUCTION BOARD DATES FOR 2018
Board Board Meeting date Applicants deadline before
Board meeting
Agendarsquos Due
Plumbing - 9am
Mechanical ndash 10am
Construction ndash 3pm
January 31 2018 January 17 2018 January 24 2018
Plumbing ndash 9am
Mechanical ndash 10 am
Construction ndash 3pm
March 28 2018 March 14 2018 March 21 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
May 30 2018 May 16 2018 May 23 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
July 25 2018 July 11 2018 July 18 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
September 26 2018 September 12 2018 September 19 2018
Plumbing ndash 9am
Mechanical ndash 10am
Construction ndash 3pm
November 14 2018 October 31 2018 November 7 2018
ELECTRICAL BOARD DATES FOR 2018
Board Board Meeting date Applicants deadline before
Board meeting
Agendarsquos Due
Electrical ndash 3pm January 4 2018 December 14 2017 December 21 2017
Electrical ndash 3pm February 1 2018 January 18 2018 January 25 2018
Electrical ndash 3pm March 1 2018 February 15 2018 February 22 2018
Electrical ndash 3pm April 5 2018 March 22 2018 March 29 2018
Electrical ndash 3pm May 3 2018 April 19 2018 April 26 2018
Electrical ndash 3pm June 7 2018 May 24 2018 May 31 2018
Electrical ndash 3pm July 5 2018 June 21 2018 June 28 2018
Electrical ndash 3pm August 2 2018 July 19 2018 July 26 2018
Electrical ndash 3pm September 6 2018 August 23 2018 August 30 2018
Electrical ndash 3pm October 4 2018 September 20 2018 September 27 2018
Electrical ndash 3pm November 1 2018 October 18 2018 October 25 2018
Electrical ndash 3pm December 6 2018 November 15 2018 November 29 2018
______________________________________ ________________________
________________________________________ ______________________________
Department of Growth Management
Acknowledgement of ExamLicensure Deadlines
Per Okaloosa County Construction Ordinance 07-32 Section 3-3 and Okaloosa County
Electrical Ordinance 07-48 Section 3-3 Eligibility Licensure by Examination
From the date of Board approval an applicant shall have one (1) calendar year to have
taken and scored a grade of at least seventy-five percent (75) or above on the Standard
Business and Law Exam and on an examination in the particular field for which the
application is being made to be prepared proctored and graded by the approved testing
agency When the passing score is achieved the applicant shall proceed with application
for State licensure Upon receipt of a State license the applicant shall provide to the
Department of Growth Management the State License business tax receipt proof of
general liability insurance workerrsquos compensation exemptioninsurance and a hold
harmless agreement to obtain a Certificate of Competency The Department shall issue
the Certificate of Competency when the above mentioned documentation is provided and
all fees are paid in full
If an applicant fails to take the exam within the one (1) calendar year after Board
approval then the applicant will be required to reapply to the appropriate Board for re-
approval
Per Okaloosa County Construction Ordinance 07-32 Section 3-12 and Okaloosa County
Electrical Ordinance 07-48 Section 3-11 Undeclared Exam Applicants
Applicants must declare ldquoactiverdquo status in Okaloosa County within twelve (12) months
from date of notification of passing the examination If active status is not declared
within one (1) year from the date of the original notice the applicant must appear before
the Board for approval to retake the examination
By signing this affidavit I understand that I will have one (1) calendar year from the date
of Board approval to take and pass the appropriate exams I further acknowledge that if I
fail to complete the requirements I will be required to reapply as a new applicant in order
to obtain re-approval
I understand once I have passed the required exams I have twelve (12) months from the
exam notification date from the Growth Management Department to declare ldquoactiverdquo
status in Okaloosa County
Applicantrsquos Signature Date Signed
NOTARY INFORMATION
State of___________________________ County of___________________________
The above applicant whose name is _____________________________________
personally appeared before me and is known by me OR has produced the following
identification ___________________________________________________________
on this ____ day of ____________ 20_____
Notaryrsquos Signature Commission Expires
SEAL
License Form 57-0913
October 2016
__________________________________________________________________________________________
___________________________________________________________________________________________
_______________________________________________________ ________________________________
OKALOOSA COUNTY DEPARTMENT OF GROWTH MANAGEMENT APPLICATION FOR COMPETENCY BOARD APPROVAL
APPLICANTrsquoS NAME ____________________________________________________ DOB _________
MAILING ADDRESS ______________________________________________________________________________
CITYSTATEZIP ________________________________________________________________________________
WORK PHONE (____) ____________________________ HOME PHONE (____) ____________________________
MOBILE PHONE (____) ______________________________ FAX (____) __________________________________
EMAIL ADDRESS ________________________________________________________________________________
TYPE OF TRADE ________________________________________________________________________________
_____ Credit Report for Applicant
_____ Work History Affidavit
_____ Experience Affidavit for Applicant
_____ $25 fee
Receipt No ___________________ Total Paid ________________ Staff Initials ______________
_____ Have you ever been convicted of a felony YES or NO
_____ Have you ever been party to an entity that has been in any form of the construction business YES or NO
If ldquoyesrdquo please state the name(s) of all entities with which you are or have been associated
_____ Have you ever had a court judgment rendered against you that remains unsatisfied YES or NO
_____ Have you ever filed for bankruptcy protection in any state YES or NO
_____ Have you ever lost any license due to failure of the licensee to pay any debt or failure to abide by the requirements of the license YES or NO
If you answer ldquoyesrdquo to any of the above three (3) questions please attach an explanation
_____ If applying for Class A Class B or Master Mechanical license do you currently hold an EPA card allowing you to handle refrigerants
_____ If you have done business in any form of construction or building in any other state please disclose the state or states in which you were involved
_____ Drivers License
Affidavit of Applicant I hereby certify that the information contained herein is true and correct to the best of my knowledge and belief
Applicantrsquos Signature Date Signed
NOTARY STATE OF __________________________ COUNTY OF______________________________ Sworn to and subscribed before me this _____ day of ____________ 20___ By __________________________ Personally Known _____ OR Produced Identification ______Type of Identification Produced _______________
Notary Signature ________________________________________
SEAL
OFFICE USE ONLY
MEETING DATE ____________________________________
MOTION MADE BY _______________________________ SECONDED BY _______________________________
VOTE ______________________________________
License Form 51-0707
(January 2017)
Untitled Document Page 1 of 1
Prov 13614 Progress Blvd
Alachua FL 32615-9496 Telephone (866) 720-7768 Prov
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Information Bulletin
Business and Law
Number of Questions 50
Time allowed (hours) 2
Subject Area Quest
Business Organization 2 Licensing 3
Lien laws 2
Tax Laws 5 Safety OSHA 3
Labor Laws 8
Contract Management 9 Project Management 6 Estimating amp Bidding 4
Financial Management 5
Risk Management 3
References
FLORIDA - NASCLA Contractors Guide to Business Law and Project Management 1st ISBN 1-934234-92-3 OR 978-1shy934234-92-1 NASCLA 23309 N 17th Drive Building 1 Unit 110 Phoenix AZ 85027 Available at wwwnasclaorg or wwwprovbookstorecom Please note the Florida Business and Law Study Guide for Contractors (published by Prov) is permitted as a substitute
~shy
httpsarkivprovexamcomarkivtffcwebdllTenF oldFCSession=Arkiv4bd5ecb 1093dee 3132018
FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD Credit Reporting Agencies ndash For Reference Only
(This listing is not all inclusive You may submit credit reports from agencies not included on this list so long as they meet the criteria listed in 61G4-12011(12) Florida Administrative Code)
DBPR cannot recommend or endorse a particular credit reporting agency The list provided below includes the agencies that we are aware of that currently meet the Boardrsquos reporting requirements It is provided solely as a
courtesy to assist you in locating resources The Department specifically disclaims any responsibility for the quality or cost of services provided by the agencies listed below
Note to Applicants Effective April 10 2012 personal credit reports must contain a FICO derived credit score to meet application requirements It is the applicantrsquos responsibility to ensure the credit reporting agency includes
the FICO derived score on the credit report submitted to DBPR
1st United CRS dba wwwunitedcrscom PH 2392061049 PH 8505398000 PH 2155017224
A amp A Credit Corp
AAA Advantage Credit Services PH 8772964600
API Processing - Licensing Inc wwwapiprocessingcom PH 9545670013 PH 8009476939
Associated Credit Reporting Inc wwwassociatedcreditreportingcom PH 7542160025 PH 8006767640 (ext 201)
AVS Screening PH 8508622134
Background Research Inc
CBJ Associates Inc PH 9047235533
Check Mate PH 9413661819
Contractor Licensing Inc
Contractors Reporting Service PH 8004872084
Credit Bureau of Escambia County
Credit Bureau Services Inc dba wwwelicensereportcom PH 9545611400
Credit Business amp License Solutions dba wwwdbprcreditreportcom PH 8006002155
Credit Check Inc wwwcreditcheckinccom PH 5616165556 TOLL FREE 8776165556
Credit Plus Inc PH 8183311048
Credit Profile amp Security Corp
Credit Search PH 5617919458
Dragnet Credit amp Tenant Screening PH 3866767733
Licenses Etc wwwlicensesetccom PH 2397771028 PH 9545732700
License Exam Services LLC PH 9417062336
Lumbermenrsquos dba wwwFloridaCreditReportscom PH 9547712100 PH 8133587633 PH 4079562237 TOLL FREE 8004964826
MacData Inc
Merchantrsquos Association
Merit Credit wwwmeritcreditservicescom PH 2392773202 TOLL FREE 8003713348
NACM Tampa Inc Contact Cassie Thomas cthomasnacmtampacom PH 8003525882 Ext 292
NACM South Atlantic wwwnacmsouthatlanticcom PH 4072997491 Ext 115 TOLL FREE 8003936226
National Research Group PH 9414888500
Network Credit Services PH 8136855678
Premium Credit Bureau PH 3054681560
Supreme Credit Information Services wwwsupremebureaucomcastnet PH 7862661407 FAX 3056653315
USA Credit Bureau PH 8884742270
Updated 11818
Department of Growth Management Licensing Division
State of Florida
List of EPA Card Training amp Testing Providers
Mingledorffrsquos of Ft Walton Beach
76 Beal Pkwy SW
(850) 244-2017 (Additional locations in Pensacola and Panama City)
Johnston Supply of Ft Walton Beach
117 Hollywood Blvd NE
(850) 362-6880 (Additional locations in Pensacola and Panama City)
Wittichen Supply of Ft Walton Beach
125 Hollywood Blvd NE
(850) 664-2740
Locklin Vo-Tech
5330 Berryhill Road
Milton
(850) 983-5700
Choice Applied Tech
1976 Lewis Turner Blvd
Ft Walton Beach
(850) 833-3500
812 E James Lee Blvd
Crestview FL 32539
(850) 651-7526 (850) 651-7184 FAX
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
______________________________________ ________________________
________________________________________ ______________________________
Department of Growth Management
Acknowledgement of ExamLicensure Deadlines
Per Okaloosa County Construction Ordinance 07-32 Section 3-3 and Okaloosa County
Electrical Ordinance 07-48 Section 3-3 Eligibility Licensure by Examination
From the date of Board approval an applicant shall have one (1) calendar year to have
taken and scored a grade of at least seventy-five percent (75) or above on the Standard
Business and Law Exam and on an examination in the particular field for which the
application is being made to be prepared proctored and graded by the approved testing
agency When the passing score is achieved the applicant shall proceed with application
for State licensure Upon receipt of a State license the applicant shall provide to the
Department of Growth Management the State License business tax receipt proof of
general liability insurance workerrsquos compensation exemptioninsurance and a hold
harmless agreement to obtain a Certificate of Competency The Department shall issue
the Certificate of Competency when the above mentioned documentation is provided and
all fees are paid in full
If an applicant fails to take the exam within the one (1) calendar year after Board
approval then the applicant will be required to reapply to the appropriate Board for re-
approval
Per Okaloosa County Construction Ordinance 07-32 Section 3-12 and Okaloosa County
Electrical Ordinance 07-48 Section 3-11 Undeclared Exam Applicants
Applicants must declare ldquoactiverdquo status in Okaloosa County within twelve (12) months
from date of notification of passing the examination If active status is not declared
within one (1) year from the date of the original notice the applicant must appear before
the Board for approval to retake the examination
By signing this affidavit I understand that I will have one (1) calendar year from the date
of Board approval to take and pass the appropriate exams I further acknowledge that if I
fail to complete the requirements I will be required to reapply as a new applicant in order
to obtain re-approval
I understand once I have passed the required exams I have twelve (12) months from the
exam notification date from the Growth Management Department to declare ldquoactiverdquo
status in Okaloosa County
Applicantrsquos Signature Date Signed
NOTARY INFORMATION
State of___________________________ County of___________________________
The above applicant whose name is _____________________________________
personally appeared before me and is known by me OR has produced the following
identification ___________________________________________________________
on this ____ day of ____________ 20_____
Notaryrsquos Signature Commission Expires
SEAL
License Form 57-0913
October 2016
__________________________________________________________________________________________
___________________________________________________________________________________________
_______________________________________________________ ________________________________
OKALOOSA COUNTY DEPARTMENT OF GROWTH MANAGEMENT APPLICATION FOR COMPETENCY BOARD APPROVAL
APPLICANTrsquoS NAME ____________________________________________________ DOB _________
MAILING ADDRESS ______________________________________________________________________________
CITYSTATEZIP ________________________________________________________________________________
WORK PHONE (____) ____________________________ HOME PHONE (____) ____________________________
MOBILE PHONE (____) ______________________________ FAX (____) __________________________________
EMAIL ADDRESS ________________________________________________________________________________
TYPE OF TRADE ________________________________________________________________________________
_____ Credit Report for Applicant
_____ Work History Affidavit
_____ Experience Affidavit for Applicant
_____ $25 fee
Receipt No ___________________ Total Paid ________________ Staff Initials ______________
_____ Have you ever been convicted of a felony YES or NO
_____ Have you ever been party to an entity that has been in any form of the construction business YES or NO
If ldquoyesrdquo please state the name(s) of all entities with which you are or have been associated
_____ Have you ever had a court judgment rendered against you that remains unsatisfied YES or NO
_____ Have you ever filed for bankruptcy protection in any state YES or NO
_____ Have you ever lost any license due to failure of the licensee to pay any debt or failure to abide by the requirements of the license YES or NO
If you answer ldquoyesrdquo to any of the above three (3) questions please attach an explanation
_____ If applying for Class A Class B or Master Mechanical license do you currently hold an EPA card allowing you to handle refrigerants
_____ If you have done business in any form of construction or building in any other state please disclose the state or states in which you were involved
_____ Drivers License
Affidavit of Applicant I hereby certify that the information contained herein is true and correct to the best of my knowledge and belief
Applicantrsquos Signature Date Signed
NOTARY STATE OF __________________________ COUNTY OF______________________________ Sworn to and subscribed before me this _____ day of ____________ 20___ By __________________________ Personally Known _____ OR Produced Identification ______Type of Identification Produced _______________
Notary Signature ________________________________________
SEAL
OFFICE USE ONLY
MEETING DATE ____________________________________
MOTION MADE BY _______________________________ SECONDED BY _______________________________
VOTE ______________________________________
License Form 51-0707
(January 2017)
Untitled Document Page 1 of 1
Prov 13614 Progress Blvd
Alachua FL 32615-9496 Telephone (866) 720-7768 Prov
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Information Bulletin
Business and Law
Number of Questions 50
Time allowed (hours) 2
Subject Area Quest
Business Organization 2 Licensing 3
Lien laws 2
Tax Laws 5 Safety OSHA 3
Labor Laws 8
Contract Management 9 Project Management 6 Estimating amp Bidding 4
Financial Management 5
Risk Management 3
References
FLORIDA - NASCLA Contractors Guide to Business Law and Project Management 1st ISBN 1-934234-92-3 OR 978-1shy934234-92-1 NASCLA 23309 N 17th Drive Building 1 Unit 110 Phoenix AZ 85027 Available at wwwnasclaorg or wwwprovbookstorecom Please note the Florida Business and Law Study Guide for Contractors (published by Prov) is permitted as a substitute
~shy
httpsarkivprovexamcomarkivtffcwebdllTenF oldFCSession=Arkiv4bd5ecb 1093dee 3132018
FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD Credit Reporting Agencies ndash For Reference Only
(This listing is not all inclusive You may submit credit reports from agencies not included on this list so long as they meet the criteria listed in 61G4-12011(12) Florida Administrative Code)
DBPR cannot recommend or endorse a particular credit reporting agency The list provided below includes the agencies that we are aware of that currently meet the Boardrsquos reporting requirements It is provided solely as a
courtesy to assist you in locating resources The Department specifically disclaims any responsibility for the quality or cost of services provided by the agencies listed below
Note to Applicants Effective April 10 2012 personal credit reports must contain a FICO derived credit score to meet application requirements It is the applicantrsquos responsibility to ensure the credit reporting agency includes
the FICO derived score on the credit report submitted to DBPR
1st United CRS dba wwwunitedcrscom PH 2392061049 PH 8505398000 PH 2155017224
A amp A Credit Corp
AAA Advantage Credit Services PH 8772964600
API Processing - Licensing Inc wwwapiprocessingcom PH 9545670013 PH 8009476939
Associated Credit Reporting Inc wwwassociatedcreditreportingcom PH 7542160025 PH 8006767640 (ext 201)
AVS Screening PH 8508622134
Background Research Inc
CBJ Associates Inc PH 9047235533
Check Mate PH 9413661819
Contractor Licensing Inc
Contractors Reporting Service PH 8004872084
Credit Bureau of Escambia County
Credit Bureau Services Inc dba wwwelicensereportcom PH 9545611400
Credit Business amp License Solutions dba wwwdbprcreditreportcom PH 8006002155
Credit Check Inc wwwcreditcheckinccom PH 5616165556 TOLL FREE 8776165556
Credit Plus Inc PH 8183311048
Credit Profile amp Security Corp
Credit Search PH 5617919458
Dragnet Credit amp Tenant Screening PH 3866767733
Licenses Etc wwwlicensesetccom PH 2397771028 PH 9545732700
License Exam Services LLC PH 9417062336
Lumbermenrsquos dba wwwFloridaCreditReportscom PH 9547712100 PH 8133587633 PH 4079562237 TOLL FREE 8004964826
MacData Inc
Merchantrsquos Association
Merit Credit wwwmeritcreditservicescom PH 2392773202 TOLL FREE 8003713348
NACM Tampa Inc Contact Cassie Thomas cthomasnacmtampacom PH 8003525882 Ext 292
NACM South Atlantic wwwnacmsouthatlanticcom PH 4072997491 Ext 115 TOLL FREE 8003936226
National Research Group PH 9414888500
Network Credit Services PH 8136855678
Premium Credit Bureau PH 3054681560
Supreme Credit Information Services wwwsupremebureaucomcastnet PH 7862661407 FAX 3056653315
USA Credit Bureau PH 8884742270
Updated 11818
Department of Growth Management Licensing Division
State of Florida
List of EPA Card Training amp Testing Providers
Mingledorffrsquos of Ft Walton Beach
76 Beal Pkwy SW
(850) 244-2017 (Additional locations in Pensacola and Panama City)
Johnston Supply of Ft Walton Beach
117 Hollywood Blvd NE
(850) 362-6880 (Additional locations in Pensacola and Panama City)
Wittichen Supply of Ft Walton Beach
125 Hollywood Blvd NE
(850) 664-2740
Locklin Vo-Tech
5330 Berryhill Road
Milton
(850) 983-5700
Choice Applied Tech
1976 Lewis Turner Blvd
Ft Walton Beach
(850) 833-3500
812 E James Lee Blvd
Crestview FL 32539
(850) 651-7526 (850) 651-7184 FAX
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
__________________________________________________________________________________________
___________________________________________________________________________________________
_______________________________________________________ ________________________________
OKALOOSA COUNTY DEPARTMENT OF GROWTH MANAGEMENT APPLICATION FOR COMPETENCY BOARD APPROVAL
APPLICANTrsquoS NAME ____________________________________________________ DOB _________
MAILING ADDRESS ______________________________________________________________________________
CITYSTATEZIP ________________________________________________________________________________
WORK PHONE (____) ____________________________ HOME PHONE (____) ____________________________
MOBILE PHONE (____) ______________________________ FAX (____) __________________________________
EMAIL ADDRESS ________________________________________________________________________________
TYPE OF TRADE ________________________________________________________________________________
_____ Credit Report for Applicant
_____ Work History Affidavit
_____ Experience Affidavit for Applicant
_____ $25 fee
Receipt No ___________________ Total Paid ________________ Staff Initials ______________
_____ Have you ever been convicted of a felony YES or NO
_____ Have you ever been party to an entity that has been in any form of the construction business YES or NO
If ldquoyesrdquo please state the name(s) of all entities with which you are or have been associated
_____ Have you ever had a court judgment rendered against you that remains unsatisfied YES or NO
_____ Have you ever filed for bankruptcy protection in any state YES or NO
_____ Have you ever lost any license due to failure of the licensee to pay any debt or failure to abide by the requirements of the license YES or NO
If you answer ldquoyesrdquo to any of the above three (3) questions please attach an explanation
_____ If applying for Class A Class B or Master Mechanical license do you currently hold an EPA card allowing you to handle refrigerants
_____ If you have done business in any form of construction or building in any other state please disclose the state or states in which you were involved
_____ Drivers License
Affidavit of Applicant I hereby certify that the information contained herein is true and correct to the best of my knowledge and belief
Applicantrsquos Signature Date Signed
NOTARY STATE OF __________________________ COUNTY OF______________________________ Sworn to and subscribed before me this _____ day of ____________ 20___ By __________________________ Personally Known _____ OR Produced Identification ______Type of Identification Produced _______________
Notary Signature ________________________________________
SEAL
OFFICE USE ONLY
MEETING DATE ____________________________________
MOTION MADE BY _______________________________ SECONDED BY _______________________________
VOTE ______________________________________
License Form 51-0707
(January 2017)
Untitled Document Page 1 of 1
Prov 13614 Progress Blvd
Alachua FL 32615-9496 Telephone (866) 720-7768 Prov
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Information Bulletin
Business and Law
Number of Questions 50
Time allowed (hours) 2
Subject Area Quest
Business Organization 2 Licensing 3
Lien laws 2
Tax Laws 5 Safety OSHA 3
Labor Laws 8
Contract Management 9 Project Management 6 Estimating amp Bidding 4
Financial Management 5
Risk Management 3
References
FLORIDA - NASCLA Contractors Guide to Business Law and Project Management 1st ISBN 1-934234-92-3 OR 978-1shy934234-92-1 NASCLA 23309 N 17th Drive Building 1 Unit 110 Phoenix AZ 85027 Available at wwwnasclaorg or wwwprovbookstorecom Please note the Florida Business and Law Study Guide for Contractors (published by Prov) is permitted as a substitute
~shy
httpsarkivprovexamcomarkivtffcwebdllTenF oldFCSession=Arkiv4bd5ecb 1093dee 3132018
FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD Credit Reporting Agencies ndash For Reference Only
(This listing is not all inclusive You may submit credit reports from agencies not included on this list so long as they meet the criteria listed in 61G4-12011(12) Florida Administrative Code)
DBPR cannot recommend or endorse a particular credit reporting agency The list provided below includes the agencies that we are aware of that currently meet the Boardrsquos reporting requirements It is provided solely as a
courtesy to assist you in locating resources The Department specifically disclaims any responsibility for the quality or cost of services provided by the agencies listed below
Note to Applicants Effective April 10 2012 personal credit reports must contain a FICO derived credit score to meet application requirements It is the applicantrsquos responsibility to ensure the credit reporting agency includes
the FICO derived score on the credit report submitted to DBPR
1st United CRS dba wwwunitedcrscom PH 2392061049 PH 8505398000 PH 2155017224
A amp A Credit Corp
AAA Advantage Credit Services PH 8772964600
API Processing - Licensing Inc wwwapiprocessingcom PH 9545670013 PH 8009476939
Associated Credit Reporting Inc wwwassociatedcreditreportingcom PH 7542160025 PH 8006767640 (ext 201)
AVS Screening PH 8508622134
Background Research Inc
CBJ Associates Inc PH 9047235533
Check Mate PH 9413661819
Contractor Licensing Inc
Contractors Reporting Service PH 8004872084
Credit Bureau of Escambia County
Credit Bureau Services Inc dba wwwelicensereportcom PH 9545611400
Credit Business amp License Solutions dba wwwdbprcreditreportcom PH 8006002155
Credit Check Inc wwwcreditcheckinccom PH 5616165556 TOLL FREE 8776165556
Credit Plus Inc PH 8183311048
Credit Profile amp Security Corp
Credit Search PH 5617919458
Dragnet Credit amp Tenant Screening PH 3866767733
Licenses Etc wwwlicensesetccom PH 2397771028 PH 9545732700
License Exam Services LLC PH 9417062336
Lumbermenrsquos dba wwwFloridaCreditReportscom PH 9547712100 PH 8133587633 PH 4079562237 TOLL FREE 8004964826
MacData Inc
Merchantrsquos Association
Merit Credit wwwmeritcreditservicescom PH 2392773202 TOLL FREE 8003713348
NACM Tampa Inc Contact Cassie Thomas cthomasnacmtampacom PH 8003525882 Ext 292
NACM South Atlantic wwwnacmsouthatlanticcom PH 4072997491 Ext 115 TOLL FREE 8003936226
National Research Group PH 9414888500
Network Credit Services PH 8136855678
Premium Credit Bureau PH 3054681560
Supreme Credit Information Services wwwsupremebureaucomcastnet PH 7862661407 FAX 3056653315
USA Credit Bureau PH 8884742270
Updated 11818
Department of Growth Management Licensing Division
State of Florida
List of EPA Card Training amp Testing Providers
Mingledorffrsquos of Ft Walton Beach
76 Beal Pkwy SW
(850) 244-2017 (Additional locations in Pensacola and Panama City)
Johnston Supply of Ft Walton Beach
117 Hollywood Blvd NE
(850) 362-6880 (Additional locations in Pensacola and Panama City)
Wittichen Supply of Ft Walton Beach
125 Hollywood Blvd NE
(850) 664-2740
Locklin Vo-Tech
5330 Berryhill Road
Milton
(850) 983-5700
Choice Applied Tech
1976 Lewis Turner Blvd
Ft Walton Beach
(850) 833-3500
812 E James Lee Blvd
Crestview FL 32539
(850) 651-7526 (850) 651-7184 FAX
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
Untitled Document Page 1 of 1
Prov 13614 Progress Blvd
Alachua FL 32615-9496 Telephone (866) 720-7768 Prov
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Information Bulletin
Business and Law
Number of Questions 50
Time allowed (hours) 2
Subject Area Quest
Business Organization 2 Licensing 3
Lien laws 2
Tax Laws 5 Safety OSHA 3
Labor Laws 8
Contract Management 9 Project Management 6 Estimating amp Bidding 4
Financial Management 5
Risk Management 3
References
FLORIDA - NASCLA Contractors Guide to Business Law and Project Management 1st ISBN 1-934234-92-3 OR 978-1shy934234-92-1 NASCLA 23309 N 17th Drive Building 1 Unit 110 Phoenix AZ 85027 Available at wwwnasclaorg or wwwprovbookstorecom Please note the Florida Business and Law Study Guide for Contractors (published by Prov) is permitted as a substitute
~shy
httpsarkivprovexamcomarkivtffcwebdllTenF oldFCSession=Arkiv4bd5ecb 1093dee 3132018
FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD Credit Reporting Agencies ndash For Reference Only
(This listing is not all inclusive You may submit credit reports from agencies not included on this list so long as they meet the criteria listed in 61G4-12011(12) Florida Administrative Code)
DBPR cannot recommend or endorse a particular credit reporting agency The list provided below includes the agencies that we are aware of that currently meet the Boardrsquos reporting requirements It is provided solely as a
courtesy to assist you in locating resources The Department specifically disclaims any responsibility for the quality or cost of services provided by the agencies listed below
Note to Applicants Effective April 10 2012 personal credit reports must contain a FICO derived credit score to meet application requirements It is the applicantrsquos responsibility to ensure the credit reporting agency includes
the FICO derived score on the credit report submitted to DBPR
1st United CRS dba wwwunitedcrscom PH 2392061049 PH 8505398000 PH 2155017224
A amp A Credit Corp
AAA Advantage Credit Services PH 8772964600
API Processing - Licensing Inc wwwapiprocessingcom PH 9545670013 PH 8009476939
Associated Credit Reporting Inc wwwassociatedcreditreportingcom PH 7542160025 PH 8006767640 (ext 201)
AVS Screening PH 8508622134
Background Research Inc
CBJ Associates Inc PH 9047235533
Check Mate PH 9413661819
Contractor Licensing Inc
Contractors Reporting Service PH 8004872084
Credit Bureau of Escambia County
Credit Bureau Services Inc dba wwwelicensereportcom PH 9545611400
Credit Business amp License Solutions dba wwwdbprcreditreportcom PH 8006002155
Credit Check Inc wwwcreditcheckinccom PH 5616165556 TOLL FREE 8776165556
Credit Plus Inc PH 8183311048
Credit Profile amp Security Corp
Credit Search PH 5617919458
Dragnet Credit amp Tenant Screening PH 3866767733
Licenses Etc wwwlicensesetccom PH 2397771028 PH 9545732700
License Exam Services LLC PH 9417062336
Lumbermenrsquos dba wwwFloridaCreditReportscom PH 9547712100 PH 8133587633 PH 4079562237 TOLL FREE 8004964826
MacData Inc
Merchantrsquos Association
Merit Credit wwwmeritcreditservicescom PH 2392773202 TOLL FREE 8003713348
NACM Tampa Inc Contact Cassie Thomas cthomasnacmtampacom PH 8003525882 Ext 292
NACM South Atlantic wwwnacmsouthatlanticcom PH 4072997491 Ext 115 TOLL FREE 8003936226
National Research Group PH 9414888500
Network Credit Services PH 8136855678
Premium Credit Bureau PH 3054681560
Supreme Credit Information Services wwwsupremebureaucomcastnet PH 7862661407 FAX 3056653315
USA Credit Bureau PH 8884742270
Updated 11818
Department of Growth Management Licensing Division
State of Florida
List of EPA Card Training amp Testing Providers
Mingledorffrsquos of Ft Walton Beach
76 Beal Pkwy SW
(850) 244-2017 (Additional locations in Pensacola and Panama City)
Johnston Supply of Ft Walton Beach
117 Hollywood Blvd NE
(850) 362-6880 (Additional locations in Pensacola and Panama City)
Wittichen Supply of Ft Walton Beach
125 Hollywood Blvd NE
(850) 664-2740
Locklin Vo-Tech
5330 Berryhill Road
Milton
(850) 983-5700
Choice Applied Tech
1976 Lewis Turner Blvd
Ft Walton Beach
(850) 833-3500
812 E James Lee Blvd
Crestview FL 32539
(850) 651-7526 (850) 651-7184 FAX
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD Credit Reporting Agencies ndash For Reference Only
(This listing is not all inclusive You may submit credit reports from agencies not included on this list so long as they meet the criteria listed in 61G4-12011(12) Florida Administrative Code)
DBPR cannot recommend or endorse a particular credit reporting agency The list provided below includes the agencies that we are aware of that currently meet the Boardrsquos reporting requirements It is provided solely as a
courtesy to assist you in locating resources The Department specifically disclaims any responsibility for the quality or cost of services provided by the agencies listed below
Note to Applicants Effective April 10 2012 personal credit reports must contain a FICO derived credit score to meet application requirements It is the applicantrsquos responsibility to ensure the credit reporting agency includes
the FICO derived score on the credit report submitted to DBPR
1st United CRS dba wwwunitedcrscom PH 2392061049 PH 8505398000 PH 2155017224
A amp A Credit Corp
AAA Advantage Credit Services PH 8772964600
API Processing - Licensing Inc wwwapiprocessingcom PH 9545670013 PH 8009476939
Associated Credit Reporting Inc wwwassociatedcreditreportingcom PH 7542160025 PH 8006767640 (ext 201)
AVS Screening PH 8508622134
Background Research Inc
CBJ Associates Inc PH 9047235533
Check Mate PH 9413661819
Contractor Licensing Inc
Contractors Reporting Service PH 8004872084
Credit Bureau of Escambia County
Credit Bureau Services Inc dba wwwelicensereportcom PH 9545611400
Credit Business amp License Solutions dba wwwdbprcreditreportcom PH 8006002155
Credit Check Inc wwwcreditcheckinccom PH 5616165556 TOLL FREE 8776165556
Credit Plus Inc PH 8183311048
Credit Profile amp Security Corp
Credit Search PH 5617919458
Dragnet Credit amp Tenant Screening PH 3866767733
Licenses Etc wwwlicensesetccom PH 2397771028 PH 9545732700
License Exam Services LLC PH 9417062336
Lumbermenrsquos dba wwwFloridaCreditReportscom PH 9547712100 PH 8133587633 PH 4079562237 TOLL FREE 8004964826
MacData Inc
Merchantrsquos Association
Merit Credit wwwmeritcreditservicescom PH 2392773202 TOLL FREE 8003713348
NACM Tampa Inc Contact Cassie Thomas cthomasnacmtampacom PH 8003525882 Ext 292
NACM South Atlantic wwwnacmsouthatlanticcom PH 4072997491 Ext 115 TOLL FREE 8003936226
National Research Group PH 9414888500
Network Credit Services PH 8136855678
Premium Credit Bureau PH 3054681560
Supreme Credit Information Services wwwsupremebureaucomcastnet PH 7862661407 FAX 3056653315
USA Credit Bureau PH 8884742270
Updated 11818
Department of Growth Management Licensing Division
State of Florida
List of EPA Card Training amp Testing Providers
Mingledorffrsquos of Ft Walton Beach
76 Beal Pkwy SW
(850) 244-2017 (Additional locations in Pensacola and Panama City)
Johnston Supply of Ft Walton Beach
117 Hollywood Blvd NE
(850) 362-6880 (Additional locations in Pensacola and Panama City)
Wittichen Supply of Ft Walton Beach
125 Hollywood Blvd NE
(850) 664-2740
Locklin Vo-Tech
5330 Berryhill Road
Milton
(850) 983-5700
Choice Applied Tech
1976 Lewis Turner Blvd
Ft Walton Beach
(850) 833-3500
812 E James Lee Blvd
Crestview FL 32539
(850) 651-7526 (850) 651-7184 FAX
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
Department of Growth Management Licensing Division
State of Florida
List of EPA Card Training amp Testing Providers
Mingledorffrsquos of Ft Walton Beach
76 Beal Pkwy SW
(850) 244-2017 (Additional locations in Pensacola and Panama City)
Johnston Supply of Ft Walton Beach
117 Hollywood Blvd NE
(850) 362-6880 (Additional locations in Pensacola and Panama City)
Wittichen Supply of Ft Walton Beach
125 Hollywood Blvd NE
(850) 664-2740
Locklin Vo-Tech
5330 Berryhill Road
Milton
(850) 983-5700
Choice Applied Tech
1976 Lewis Turner Blvd
Ft Walton Beach
(850) 833-3500
812 E James Lee Blvd
Crestview FL 32539
(850) 651-7526 (850) 651-7184 FAX
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
Untitled Document Page 1 of 2
Prov 13614 Progress Blvd
Alachua Fl 32615-9496 Telephone (866) 720-7768 ProV
Website arkivprovexamcom
You have received this email in response to your request for Exam Information for Okaloosa County The information below describes the examination you expressed interest in taking To receive more general information about the testing program you may click on the Candidate Information Bulletin link below to download a candidate bulletin that provides more detailed information about the testing rules and processes
Candidate Info rmation Bulletin
Master AC (Limited)
Number of Questions 100
Time allowed (hours) 4
Subject Area Quest General Knowledge 18
Piping 19 Systems amp Sizing 20
Equipment 15
Maintenance 23
Plan Reading 5
References
Advanced Mechanical Study Guide 2013 ISBN 978-1-269-09518-1 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Florida Building Code 2017 - Building 2017 ISBN 978-1-60983-687-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Energy Conservation 2017 ISBN 978-1-60983-695-5 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Fuel Gas 2017 ISBN 978-1-60983-691-7 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
Florida Building Code 2017 - Mechanical 2017 ISBN 978-1-60983-690-0 International Code Council 4051 West Flossmoor Road Country Club Hills IL 60478 wwwiccsafeorg
HVAC Basics for Contractors 2nd Edition 2013 ISBN 978-1-269-23865-6 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Intermediate Mechanical Study Guide 2013 ISBN 978-1-269-09524-2 Pearson 501 Boylston Street Suite 900 Boston MA 02116 Available at wwwprovbookstorecom
Manual N - Commercial Load Calculations 2008 ISBN 978-1892765383 Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 Available at httpwwwacca org
Residential Load Calculations - Manual J Air Conditioning Contractors of America 2800 Shirlington Road Suite 300 Arlington VA 22206 wwwaccaorg
I
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
Okaloosa County Department of Growth Management
Licensing Department
Class A Class B Mechanical amp Sheet Metal Contractor Board Application Directions
This is to assist you in completing your application to appear before the Mechanical Competency Board
in obtaining approval for testing and Okaloosa County Competency Card
Application for Competency Board Approval Affidavit 51-0707 a Complete Name date of birth address phonefax numbers email address and type of trade applying for
(ie Residential Contractor Roofing Contractor Electrical Contractor etc) b Circle lsquoYesrsquo or lsquoNorsquo for each of the questions listed on the form
1 If answer lsquoyesrsquo to felony you will be required to provide the following a Date of offense
b Type of offense charged with
c Time Served if any d Complete description of chargersquo e State felony was in
2 If answer lsquoyesrsquo to judgment you will be required to provide the following
f Proof that judgment has been satisfied
g Proof payment plan is in place 3 If answer lsquoyesrsquo to bankruptcy you will be required to provide the following
h Provide copy of Discharge of Bankruptcy 4 If answer lsquoyesrsquo to loss of license due to debt or license requirements you will be required to provide
i Written explanation
c Applicant must sign form and hisher signature must be notarized
Credit Report The report must be provided from one of the agencies listed on the Credit Reporting Agency Approved List The credit report can be submitted as follows
1 Mailed from the credit reporting agency to Okaloosa County Dept of Growth Mgmt 812 E James Lee Blvd Crestview FL 32539
2 By applicant at the time packet is submitted Envelope MUST be sealed 3 Emailed from the credit reporting agency to rlucasmyokaloosacom
Proof of Satisfaction of Liens Judgment or Discharge of Bankruptcy if applicable Applicant will be required to submit proof that all liens or judgments have been satisfied or payment plan is in
place or provide a copy of the discharge of bankruptcy
Class AClass B Mechanical and Sheet Metal Contractor Experience Affidavit 10-0503 1 Mark one (1) of the areas listed based on related experience
If using two (2) years of credits from an accredited institution a copy of the transcripts must accompany this
affidavit 2 Applicant must complete their name and date of birth
3 A licensed contractor who holds a current and active state license in the fields listed must sign the affidavit and their signature must be notarized
If the contractor signing the affidavit is licensed outside of the State of Florida please make himher aware that Licensing Staff will be contacting them as required by the Competency Boards
Work History Affidavit 52-0707 1 Complete your name address and contact number(s)
2 Complete employercompany name 3 Complete position held with company
4 Complete length of time employed showing starting (monthyear) and ending or current (monthyear) 5 Type of workduties performed ndash please be as descriptive as possible May use additional paper if
needed
6 Signature of Applicant must be notarized
Acknowledgement of ExamLicensure Deadline Affidavit 57-0913 Applicant must sign affidavit and hisher signature must be notarized
NOTE All forms submitted must be an original
1
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
___________________________________________ ___________________________________________
___________________________________________ ___________________________________________
______________________________________ ________________________________________
Okaloosa County Mechanical Contractorrsquos Experience Affidavit
A person shall be entitle to take the examination for the purpose of determining whether he or
she is qualified to engage in Mechanical Contracting Class A Air Conditioning Contracting
Class B Air Conditioning Contracting and Sheet Metal Contracting throughout Okaloosa
County if the person is 22 years of age or older and meets eligibility requirements according to
one of the following criteria
______1 Has received a Baccalaureate degree from an accredited institution in the appropriate
field of Engineering and has one (1) year proven experience in the mechanical field
(Related degree is Mechanical Engineering)
______2 Has at least four (4) years of active proven experience as a workman in his trade
______3 Has a combination of not less than Two (2) years of proven experience as a skilled
workman and not less than two (2) years of credits from an accredited institution level courses
relative to the trade in which the applicant is to be tested
For the purpose of experience requirements a minimum of 2000 man-hours shall be used in determining one
(1) year of work experience per Okaloosa County Ordinance 07-32
License Applying For Licensed Individuals Authorized to Sign Experience Affidavit
Class A Air Conditioning Class A Air Conditioning Contractor Mechanical Contractor General Building or
Residential Contractor or Building Official
Class B Air Conditioning Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor or Building Official
Mechanical Contractor Mechanical Contractor Class A or Class B Air Conditioning Contractor General
Building or Residential Contractor or Building Official
Sheet Metal Contractor Class A or Class B Air Conditioning Contractor Mechanical Contractor General
Building or Residential Contractor Sheet Metal Contractor or Building Official
NOTE MISREPRESENTATION OF INFORMATION ON THIS APPLICATION MAY RESULT IN DENIAL OF THIS
APPLICATION I understand DIRECT KNOWLEDGE does NOT mean I am relying on a statement from the applicant that heshe has
met the requirements Furthermore knowingly providing false or misleading information andor committing forgery may be subject to
criminal penalties including but not limited to those set forth in chapter 817 Florida Statutes and chapter 831 Florida Statutes
Name of Applicant____________________________________________________________ DOB ___________
Print Name of Person Verifying Experience Address
State License Number amp State Licensed In Phone Number with Area Code
I certify that the above information is true and correct this ___________ day of ___________________20____
______________________________________________ I further acknowledge that I have not knowingly provided
Signature of person verifying experience false or misleading information
STATE OF _________________________________ COUNTY OF ____________________________________
The above license holder whose name is ____________________________ personally appeared before me and is
known by me or has produced identification (type of ID) _______________________________
on this _____ day of ______________________ 20 _____
Notaryrsquos Signature My Commission Expires
License Form 10-0503
(October 2016)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
-
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OKALOOSA COUNTY Work History Affidavit
Name of Applicant __________________________________________________________________________________
Home Address _____________________________________________________________________________________
Home Phone ______________________ Work Phone _____________________ Mobile Phone ____________________
WORK EXPERIENCE Must be listed in chronological order starting with the most current employment You may attach additional sheets if necessary in order to give complete and detailed information ALL RELEVANT EXPERIENCE IN THE FIELD IN WHICH YOU ARE APPLYING FOR MUST BE SHOWN AND MUST BE LEGIBLE
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
EMPLOYER ____________________________________________ YOUR TITLE _______________________________________
EMPLOYER ADDRESS ______________________________________________________________________________________
START DATE (MonthYear) _______ END DATE (MonthYear) _______ SUPERVISORrsquoS NAME ________________________
YOUR SPECIFIC DUTIES _____________________________________________________________________________________
Applicant Signature ___________________________________________________ Date ________________________
STATE OF _____________________________________ COUNTY OF _____________________________________
The foregoing document was acknowledged before me this _____ day of _____________ 20___ By __________________________________________________ Who is personally known by me or produced the following identification _______________________________________
__________________________________________________________
Signature of Notary Public
SEAL License Form 52-0707
(October 2016)
- Class B Air Conditioning Contractor Cover Sheet 2016
- 2018 Board Dates amp Deadlines
- Acknowledgement of Exam Licensure Deadlines
- Board Application for Approval
- Business amp Law
- cilb_credit_reporting_agencies
- EPA CARD providers
- Master AC (Limited)
- Mechanical (Class B) Contractor Packet Directions
- Mechanical Contractor Affidavit
- Work History Affidavit
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